Objective To evaluate the efficacy and safety of levonorgestrel combined with danazol capsules in the treatment of endometriosis patients.Methods Ninety patients with endometriosis were randomLy divided into experimental group and control group(45 cases).The control group was treated with danazol capsules.The experimental group was treated with levonorgestrel on the basis of the control group.The clinical efficacy and serum CA125,CA199,ovarian function,and ovarian function were observed before and one month and three months after treatment.Adverse reaction rate.Results After three months of treatment,the clinical symptoms of the experimental group were lower than the control group(P<0.05); serum CA125,CA199 levels decreased,compared with the control group,the test group decreased significantly(P<0.05); ovarian function recovery Compared with the control group,the difference was statistically significant(P<0.05).two group compared with the incidence of adverse reactions,the difference was not statistically significant.Conclusion Levonorgestrel danazol capsules treatment of endometriosis Bitter patients than the use of danazol capsules better treatment,higher safety,worthy of clinical application to promote.

Objective To evaluate the feasibility of renal artery angiography with interpolated finite impulse response (IRFR) sequence on 1.5T MR. Methods A total of 122 subjects underwent MR scan with IFIR sequence. On axial image of IFIR, bilateral signal-to-noise ratio (SNR) and breath artifact of renal artery were measured and 3D maximum intensity projection (MIP) images were reconstructed on workstation ADW 4.3, and each branch was scored according to its displaying quality. Influence of SNR, age and breath artifact on the displaying of renal artery were compared and analyzed. Results Renal segmental artery could be seen in 112 subjects (91.80%). Among them, segmental artery was showed clearly in 78 subjects (63.93%), post-segmental artery was showed in 54 subjects (44.26%) and branches of post-segmental artery was showed in 22 subjects (18.03%). There was statistical difference of renal artery scores mean rank between ≥60 years group and ＜60 years group (49.25 vs 67.48, P=0.006), as well as between the group without and with breath artifact (66.66 vs 43.35, P=0.002). No statistical difference of SNR was found among renal artery scores from 1-5 (P=0.177). Conclusion IFIR sequence is simple and safe for renal artery angiography on 1.5T MR, and different grades of renal artery branch can be showed clearly.

Objective To investigate the feasibility of immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy in early stage breast cancer.Methods From Jan.2006 to Nov.2009,28 breast cancer patients underwent immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy.Results Among the 28 patients,27 were satisfied with the apperance of their breast after operation.Conclusions Immediate breast reconstruction by implanting silicone prosthesis wrapped by ectopectoralis after nipple-sparing mastectomy not only ensures the curative effects but also beautifies the apperance of the breast.The operation has the advantages of simplity,less trauma and quick recovery.There is no difference compared with mastectomy in terms of complication,recurrence rate and mortality etc.

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.

Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.

Objective To study the effect of small dose mifepristone in the treatment of uterine fibroids.Methodsfrom January 2013~2015 year in January 100 cases of uterine fibroids were treated in Yiwu Maternal and Child Health Care Family Planning Center as the research object in the course of the study, patients began taking mifepristone in menstruation third days to 5 days, taking a total of 6.5 months, after the observation of its long-term use of low-dose mifepristone after treatment, changes in sex hormone the level of the effect of low-dose mifepristone in the treatment of patients with uterine fibroids and patients in the body, including the effects on the endometrium.The clinical symptoms and signs, the changes of hormone levels and the results of B-ultrasound were followed up.ResultsAll of the 100 patients were treated with low dose mifepristone for a period of time, all of them had amenorrhea.Before treatment, the level of estradiol in patients was (298.5±156) pmol/L, and the level of progesterone (2.8±1.3) was pmol/L.After 6.5 months of treatment, the level of estradiolof the patients was(228.4±114)pmol/L, and the level of progesterone(1.3±0.5)pmol/L was pmol/L.The results showed that the levels of progesterone and estradiol in patients after treatment were significantly lower than those before treatment, with statistical difference (P<0.05).There was no significant change in endometrial thickness after long-term low-dose mifepristone treatment (P>0.05).After treatment, the total effective number of cases was 92 cases, the effective rate was 92%.ConclusionSmall dose of mifepristone for uterine fibroids clinical treatment effect is good, to a large extent, improve the effective rate of treatment and high safety, with the clinical significance of further promotion and application.

Aim To investigate the expression of G protein-coupled receptor TGR5 and its effects on FN and TGF-β1 expression cultured under high glucose condition in rat glomerular mesangial cells , and then to explore the role of TGR5 in diabetic nephropathy. Methods INT-777 and TGR5 plasmid were used to activate TGR5 under high glucose(HG,30 mmol·L - 1 glucose ) condition, and anti-TGR5 small interfering RNA(TGR5 siRNA) was used to knock down TGR5. The protein expression of FN and TGF-β1 in rat me-sangial cells was detected by Western blot. Results TGR5 could be detected in rat glomerular mesangial cells. Both FN and TGF-β1 protein levels could be in-creased by high glucose compared with control group(P < 0. 05),and be inhibited by activiation of TGR5(P <0. 05). On the other hand,knockdown of TGR5 could increase FN and TGF-β1 protein to abnormal levels(P< 0. 01,P < 0. 05). Conclusion TGR5 suppresses HG-induced FN and TGF-β1 expression in rat glomer-ular mesangial cells,suggesting a protective role in the process of diabetic nephropathy.

Objective To investigate the major risk factors for posterior circulation stroke and the clinical and imaging features of posterior circulation stroke patients with diabetes.Methods The patients with acute cerebral infarction were enrolled.The clinical data of patients with posterior circulation and anterior circulation stroke were compared.The patients with posterior circulation stroke were further divided into either a diabetic group or a non-diabetic group,and the vascular risk factors and imaging features of both groups were compared.The patients with posterior circulation stroke were divided into proximal segment,middle segment and distal segment and mixed groups according to the distribution of vascular lesions.The correlations between diabetes and each group and the imaging features were analyzed.Results A total of 328 patients with posterior circulation stroke (male 194,the diabetic group 108) and 336 patients with anterior circulation stroke (male 214,the diabetes group 59)were enrolled.The proportions of patients with diabetes (32.9％ vs.21.7％ ; x2 =10.501,P =0.001),hyperlipidemia (60.1％ vs.47.9％ ;x2 =9.852,P =0.002),previous stroke or transient ischemic attack (TIA) (29.0％ vs.22.0％ ;x2 =4.213,P =0.040) in the posterior circulation ischemic stroke group were significantly higher than those in the anterior circulation ischemic stroke group,and the proportion of smoking patients was significantly lower than that in the anterior circulation ischemic stroke group (18.3％ vs.26.2％ ; x2 =5.977,P =0.014).The levels of total cholesterol (4.72 ±1.07 mmol/L vs.4.56 ± 0.98 mmol/L; t =2.079,P =0.038),triglycerides (1.54 ± 1.07 mmol/L vs.1.33±0.71 mmol/L; t=3.085,P=0.002) and low-density lipoprotein cholesterol (2.91±0.90 mmol/L vs.2.75 ±0.80 mmol/L; t =2.373,P =0.018) were significantly higher than those in the anterior circulation ischemic stroke group,and the level of high-density lipoprotein cholesterol was significantly lower than that in the anterior circulation ischemic stroke group (1.13 ± 0.31 mmol/L vs.1.18 ±0.32 mmol/L; t =2.045,P=0.041).Multivariate logistic regression analysis showed that diabetes (odds ratio [OR] 1.560,95％ confidence interval [CI] 1.086-2.239; P =0.016) and previous stroke or TIA history (OR 1.455,95％ CI 1.013-2.090; P =0.042) were the independent risk factors for posterior circulation ischemic stroke.In patients with posterior circulation ischemic stroke,the patient's proportions of hyperllpidemia (66.7％ vs.55.5％ ;x2 =5.069,P =0.024) and drinking (13.0％ vs.4.5％;x2 =7.568,P=0.006) in the diabetic group (n =108) were significantly higher than those in the non-diabetic group (n =220); the proportion of atrial fibrillation patients was significantly lower than that in the non-diabetic group (3.7％ vs.11.4％ ;x2 =5.274,P =0.022).The levels of triglycerides (1.70 ± 0.93 rnmol/L vs.1.45 ± 1.11 mmol/L; t =1.989,P =0.048),fasting glucose (8.46 ± 2.96) mmol/L vs.5.30± 0.96 mmol/L; t=10.706,P=0.000) and glycosylated hemoglobin (8.36％ ± 1.94％ vs.6.07％ ± 0.55％ ; t =10.576,P =0.000) in the diabetic group were significantly higher than those in the non-diabetic group.The proportion of patients with large artery atherosclerosis stroke in the diabetic group was significantly higher than that in the non-diabetic group (73.1％ vs.60.0％; x2=5.457,P=0.019); the proportion of the patients with cardioembolism was significantly lower than that of the non-diabetic group (2.8％ vs.9.1％;x2 =4.428,P =0.035).The proportion of patients with posterior circulation middle segment infarction in the diabetic group was significantly higher than that of the non-diabetic group (49.1％ vs.31.4％ ;x2 =9.726,P =0.002).The proportions of the patients with brainstem infarction (60.2％ vs.48.2％ ;x2 =4.182,P =0.041) and single brainstem infarction (55.6％ vs.30.5％ ;x2 =19.235,P =0.000) in the diabetic group were significantly higher than those in the non-diabetic group.In patients with single brainstem infarction,the proportions of the patients with pontine infarction (43.5％ vs.25.9％ ;x2 =10.374,P =0.001) and medulla oblongata infarction (7.4％ vs.1.8％ ; P =0.023) in the diabetic group were significantly higher than those in the non-diabetic group.Conclusions Diabetes and previous stroke or TIA history are the independent risk factor for posterior circulation stroke.Diabetes is closely associated with brainstem infarction,and it is more likely to result in pontine infarction.

Objective To explore the efficacy of intervention combined with traditional Chinese medicine for the treatment of early femoral head necrosis. Methods 62 cases of early femoral head necrosis were treated with interventional and traditional Chinese medicine, all patients were assessed for clinical efficacy before treatment and 6 months after treatment. The clinical hip function, pain index evaluation and rating of the femoral head venography were recorded. Results 41 cases were cured, 18 cases improved,no improvement in 3 cases,the total effective rate was 95. 2%. Clinical hip function after treatment compared with before treatment increased by 32.5%,there was a statistically significant difference (P＜0.01); compared with before treatment, significantly reduced pain (P＜0. 01). After treatment, Ⅲ and Ⅳ were significantly increased number of cases, respectively, compared with the preoperative increase of 146.2% and 160.0%,femoral venography ratings before and after treatment had significant difference(P＜0.01). Conclusion Intervention combined with traditional Chinese medicine treatment could significantly improve the early femoral head necrosis.

BACKGROUND: It is reported that ceramide signal pathway may play an important role in the apoptosis of vascular endothelial cell and then lead to the progress of atherosclerosis, such as the formation of foam cells and the proliferation of smooth muscular cells.OBJECTIVE: To study the changes of the sphingomylinase activity and ceramide content in aorta of rabbits with experimental atherosclerosis and investigate the regulative effects and mechanism of emodin on them as compared with positive fenofibrate.DESIGN: Completely randomized controlled design.SETTING: Laboratory of Pharmacology & Toxicology, School of Pharmaceutical Science of Sun Yat-sen University.MATERIALS: The experiment was completed at the Laboratory of Pharmacology & Toxicology, School of Pharmaceutical Science of Sun Yat-sen University from July to December 2003. Totally 48 New Zealand male rabbits were selected. Forty animal models of atherosclerosis were made with high cholesterol feed, and the other 8 rabbits were selected as the normal controls. Model animals were divided randomly into model group, 5 mg/kg emodin group, 10 mg/kg emodin group, 20 mg/kg emodin group and 25mg/kg fenofibrate group with 8 in each group.METHODS: At the seventh weeks of model duplication, 5 mg/kg, 10 mg/kg and 20 mg/kg emodin were perfused in rabbits of emodin groups respectively, and 25 mg/kg fenofibrate was perfused in rabbits of fenofibrate group. Emodin and fenofibrate were diluted or suspensed with 2 mL saline once per day respectively. Rabbits in normal control group and model group were administrated with the same volume of saline for 4 weeks. The rabbits were raised separately and were fed with 135-150 g food per day.MAIN OUTCOME MEASURES: [1] The area of the lipid plaque in aortal intima; [2] the content of serum TC and TG; [3] SOD activity and MDA content; [4] SMase activity and CER content in aorta.RESULTS: Totally 48 rabbits entered the final analysis. [1] Area of the lipid plaque: Area of the lipid plaque was (48.87±15.5) % in the model group, which was larger than that in each emodin group (P ＜ 0.05 or 0.01),especially larger than that in the 10 mg/kg emodin group (22.19±12.9)%while that in the fenofibrate group was similar to that in the model group (P ＞ 0.05). [2] Content of serum TC and TG: The anrtal intima of control was smooth. Content of serum TC and TG in each emodin group were similar to those in the model group (P ＞ 0.05), but those in the 25 mg/kg fenofibrate group were lower than those in the model group (P ＜ 0.05). [3]Content of SOD and MDA in plasma: SOD activity of rabbits in each emodin group was higher than that in the model group (P ＜ 0.05, P ＜ 0.01),but the MDA activity in the 10 mg/kg and 20 mg/kg emodin group was lower than that in the model group (P ＜ 0.05). The MDA activity in the25 mg/kg fenofibrate group was similar to that in the model group (P ＞ 0.05).[4] Content of SMase and CER: Those in the model group were higher than those in the normal control group, but those in the 5, 10 and 20 mg/kg emodin groups were lower than those in the model group; those in the 25 mg/kgfenofibrate group were similar to those in the model group (P ＞ 0.05). [5]Analysis of correlation: Content of SMase was in positive relation with blood cholesterol (r=0.542, P ＜ 0.01), in positive relation with blood MDA (r=0.789, P ＞ 0.01), and in negative relation with blood SOD(r=-0.936, P ＞ 0.01); content of CER was in positive relation with blood cholesterol (r=0.433, P ＞ 0.05), in positive relation with blood MDA (r=0.673, P ＞ 0.01), and in negative relation with blood SOD (r=-0.876, P ＞ 0.01).CONCLUSION: The study finds that emodin, despite its insignificant effects on decreasing TG or TC, can protect vascular endothelial cells and reduce the area of lipid-laden plague of aortal intima by antioxidation, inhibition of the sphingomyelinase activity and reduction of the content of ceramide. It is suggested that moderate dosage of emodin employed in the study may be most appropriate to atherosclerosis treatment.